TY - JOUR
T1 - Predictors of progression of cognitive decline in Alzheimer's disease
T2 - The role of vascular and sociodemographic factors
AU - Musicco, Massimo
AU - Palmer, Katie
AU - Salamone, Giovanna
AU - Lupo, Federica
AU - Perri, Roberta
AU - Mosti, Serena
AU - Spalletta, Gianfranco
AU - Di Iulio, Fulvia
AU - Pettenati, Carla
AU - Cravello, Luca
AU - Caltagirone, Carlo
PY - 2009/8
Y1 - 2009/8
N2 - Rates of disease progression differ among patients with Alzheimer's disease, but little is known about prognostic predictors. The aim of the study was to assess whether sociodemographic factors, disease severity and duration, and vascular factors are prognostic predictors of cognitive decline in Alzheimer's disease progression. We conducted a longitudinal clinical study in a specialized clinical unit for the diagnosis and treatment of dementia in Rome, Italy. A total of 154 persons with mild to moderate Alzheimer's disease consecutively admitted to the dementia unit were included. All patients underwent extensive clinical examination by a physician at admittance and all follow-ups. We evaluated the time-dependent probability of a worsening in cognitive performance corresponding to a 5-point decrease in Mini-Mental State Examination (MMSE) score. Survival analysis was used to analyze risk of faster disease progression in relation to age, education, severity and duration of the disease, family history of dementia, hypertension, hypercholesterolemia, and type 2 diabetes. Younger and more educated persons were more likely to have faster Alzheimer's disease progression. Vascular factors such as hypertension and hypercholesterolemia were not found to be significantly associated with disease progression. However, patients with diabetes had a 65% reduced risk of fast cognitive decline compared to Alzheimer patients without diabetes. Sociodemographic factors and diabetes predict disease progression in Alzheimer's disease. Our findings suggest a slower disease progression in Alzheimer's patients with diabetes. If confirmed, this result will contribute new insights into Alzheimer's disease pathogenesis and lead to relevant suggestions for disease treatment.
AB - Rates of disease progression differ among patients with Alzheimer's disease, but little is known about prognostic predictors. The aim of the study was to assess whether sociodemographic factors, disease severity and duration, and vascular factors are prognostic predictors of cognitive decline in Alzheimer's disease progression. We conducted a longitudinal clinical study in a specialized clinical unit for the diagnosis and treatment of dementia in Rome, Italy. A total of 154 persons with mild to moderate Alzheimer's disease consecutively admitted to the dementia unit were included. All patients underwent extensive clinical examination by a physician at admittance and all follow-ups. We evaluated the time-dependent probability of a worsening in cognitive performance corresponding to a 5-point decrease in Mini-Mental State Examination (MMSE) score. Survival analysis was used to analyze risk of faster disease progression in relation to age, education, severity and duration of the disease, family history of dementia, hypertension, hypercholesterolemia, and type 2 diabetes. Younger and more educated persons were more likely to have faster Alzheimer's disease progression. Vascular factors such as hypertension and hypercholesterolemia were not found to be significantly associated with disease progression. However, patients with diabetes had a 65% reduced risk of fast cognitive decline compared to Alzheimer patients without diabetes. Sociodemographic factors and diabetes predict disease progression in Alzheimer's disease. Our findings suggest a slower disease progression in Alzheimer's patients with diabetes. If confirmed, this result will contribute new insights into Alzheimer's disease pathogenesis and lead to relevant suggestions for disease treatment.
KW - Cognitive decline
KW - Dementia
KW - Diabetes
KW - Disease progression
KW - Education
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U2 - 10.1007/s00415-009-5116-4
DO - 10.1007/s00415-009-5116-4
M3 - Article
C2 - 19353221
AN - SCOPUS:68349145968
VL - 256
SP - 1288
EP - 1295
JO - Journal of Neurology
JF - Journal of Neurology
SN - 0340-5354
IS - 8
ER -